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Its time to view public health care as an economic asset

A version of this commentary appeared in the Calgary Herald, Huffington Post and the Winnipeg Free Press T he road to reviving Canadas sluggish productivity may lead straight to an emergency department or an operating room or an immunization clinic. Sound implausible? Only if you consider public health care f rom the tired and usual point of view which is that it is a consumption good, sucking ever-larger amounts of money out of a shrinking taxpayer pocket. Strike another commission, Canada. But if you can accept the notion that public health care, if optimized, could be an investment good yielding f uture wealth as opposed to a consumption good using up current wealth and resources, the road to reversing our productivity slide seems suddenly to be f reshly paved. Take a pass on the commission, Canada. Take a progressive look at public health care. Health care is a f orm of human capital. Considered in the broadest sense, health care encompasses public education and prevention services as well as the delivery of care when illness strikes. As such, it is actually one of societys critical means of keeping our population productive. T he correlation between health and productivity has been illustrated in dif f erent ways. T he Canadian Institutes of Health Research estimated the outbreak of severe acute respiratory syndrome (SARS) in 2003 took US$3.6 billion out of Canadas GDP and 1% of f its economic growth. Imagine the consequences both economic and human had SARS gone unchecked. More recently, the Fraser Institute estimated that work-time productivity losses due to long waits at hospitals and to see specialists cost the Canadian economy C$1.08 billion in 2011. T he cost tripled to $3.29 billion when time outside of the working period was included. T hese examples are at the system level. T hink of the value impacts, as well, at the individual level: having a worn out joint replaced or having a heart attack treated can allow people to remain productive f or years beyond what would have been their original shelf lif e. Canadians cant af f ord productivity losses. Weve had two decades of sluggish productivity growth. T he Conf erence Board of Canada reported last year that our productivity level has f allen to 80% of the U.S. level f rom a high of 90% in the mid-1980s. If we can agree that ef f icient health care is an enabler of productivity and that productivity is key to wealth, the next steps should be easy: f irst, view public health care as a signif icant driver of our economy; next, consider our expenditures in health care as a potential investment yielding f uture wealth; and f inally, manage those investments strategically to ensure we get maximal value f or our money. T he latter will take much ef f ort given the inef f iciencies in public health care in Canada.

T his would be a cathartic and def ining shif t f or Canadians, who have been locked in a philosophical debate over public vs. private health care. In f act, the core issue should be how to get maximal value f or all of our health dollars. T his not about spending more or spending less; its about investing f or value. Show me the value should be the new mantra in public health care. Indeed, it seems to be gaining traction. T he premiers last year created a Working Group on Health Care Innovation to enhance patient care and improve value f or taxpayers. Ontarios government this year announced an action plan that will shif t f unding to where we get the best value. T his summer, Albertas health care agency, Alberta Health Services, launched its f irst group of Strategic Clinical Networks, a new concept in public health care in Canada. T hey will bring together medical practitioners, patients, business people, researchers and others in teams that conceive and carry out projects aimed at improving health care services to achieve outcomes f or all Albertans and generating measurable value f or the public money invested. We appear to be f inally moving away f rom viewing public health care as an economic burden. T he new view emerging is that of an extremely valuable asset an asset that is a big part of the economy and can be managed better and exploited more f ully by drawing on the bright minds, unique perspectives and special skills that exist in the medical, business, social and academic communities. As this asset strengthens, productivity will continue to grow and the important correlation between strategic health care investments and our economy will become abundantly clear. Cy Frank is an expert adviser with EvidenceNetwork.ca, the Executive Director of the Alberta Bone and Joint Health Institute, and an orthopaedic surgeon practising in Calgary. He is also professor of surgery in the division of orthopaedics at the University of Calgary, the McCaig Professor of Joint Injury and Arthritis Research and the Max Bell Senior Policy Fellow.